This case is an excellent example of how creative therapy skills are invaluable in certain situations.This young girl came to therapy almost a year after being gang raped by three male acquaintances in a brutal and violent way. She didn’t tell anyone that this had occurred until she became so symptomatic that she finally broke down and told her mother.From the beginning of the therapy she tried very hard to talk about what happened, but even with my careful pacing of each session, she would get so overwhelmed so quickly, it was impossible for her to talk about the event even for brief moments. To my surprise, even art therapy and play therapy were too overwhelming.In these cases, it is often advantageous to have a child just spend time in the therapy office for the first few sessions, getting comfortable and engaging in more benign activities, taking the focus off “therapy,” and keeping things fun and light. We played board games, got to know each other, played some guessing games, and she started looking forward to coming.After a few sessions like this, she looked troubled, and when I inquired, she talked about how she really did want to talk about “the bad thing that happened,” but that she was afraid. We tried some more art, and play, and creative tools, but each time she began to panic, even though I encouraged art projects that were “just for fun” (because art therapy always heals on an unconscious level, whether it is art related to the traumatic event or not,) but she was still frightened. Then I had a creative idea that worked.

I told her that when people get overwhelmed, it is usually because the thing that is overwhelming them is too big to manage. And that what happened to her was very, very, big. And awful. And that because she kept it a secret for so long it probably felt even bigger. I asked her what it would be like if she told me just one very, very small part of the story at the beginning of each session, for maybe just five minutes, and we could write it down on a piece of paper, and put it away. And then we could relax, and hang out, and play our games, and have fun, and talk about school, and whatever else. She agreed to try.I got the paper and asked her to put the date. She did, and wrote ‘The sexual abuse happened on (date.)’ And we put the paper away and played a game. The next session, I took out the paper, and she put the date, and wrote ‘It happened in the basement of my building.’ And she put the paper away. And on it went. What she was wearing. Who said what. How they tricked her. One line a week, to start.Soon, she wasn’t putting the paper away so quickly. She would talk for a few more minutes about the line she had written, or ask me questions. Other days, the paper wouldn’t come out at all, if it was a particularly bad point in the event. When we were several months (and pages) into the work, she didn’t want to play board games anymore when we put the paper away. She started drawing. And talking. And crying. And laughing. And having family sessions that were rich with love, support, and pride.